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Background and Objectives: Progressive familial intrahepatic cholestasis (PFIC) is a rare autosomal recessive inherited disease divided into five types (PFIC 1-5). Characteristic for all types is early disease onset, which may result clinically in portal hypertension, fibrosis, cirrhosis, hepatocellular carcinoma (HCC), and extrahepatic manifestations. Liver transplantation (LT) is the only successful treatment approach. Our aim is to present the good long-term outcomes after liver transplantation for PFIC1, focusing on liver function as well as the occurrence of extrahepatic manifestation after liver transplantation. Materials and Methods: A total of seven pediatric patients with PFIC1 underwent liver transplantation between January 1999 and September 2019 at the Department of Surgery, Charité Campus Virchow Klinikum and Charité Campus Mitte of Charité-Universitätsmedizin Berlin. Long-term follow-up data were collected on all patients, specifically considering liver function and extrahepatic manifestations. Results: Seven (3.2%) recipients were found from a cohort of 219 pediatric patients. Two of the seven patients had multilocular HCC in cirrhosis. Disease recurrence or graft loss did not occur in any patient. Two patients (male, siblings) had persistently elevated liver parameters but showed excellent liver function. Patient and graft survival during long-term follow-up was 100%, and no severe extrahepatic manifestations requiring hospitalization or surgery occurred. We noted a low complication rate during long-term follow-up and excellent patient outcome. Conclusions: PFIC1 long-term follow-up after LT shows promising results for this rare disease. In particular, the clinical relevance of extrahepatic manifestations seems acceptable, and graft function seems to be barely affected. Further multicenter studies are needed to analyze the clinically inhomogeneous presentation and to better understand the courses after LT.
Safak Gül-Klein; Robert Öllinger; Moritz Schmelzle; Johann Pratschke; Wenzel Schöning. Long-Term Outcome after Liver Transplantation for Progressive Familial Intrahepatic Cholestasis. Medicina 2021, 57, 854 .
AMA StyleSafak Gül-Klein, Robert Öllinger, Moritz Schmelzle, Johann Pratschke, Wenzel Schöning. Long-Term Outcome after Liver Transplantation for Progressive Familial Intrahepatic Cholestasis. Medicina. 2021; 57 (8):854.
Chicago/Turabian StyleSafak Gül-Klein; Robert Öllinger; Moritz Schmelzle; Johann Pratschke; Wenzel Schöning. 2021. "Long-Term Outcome after Liver Transplantation for Progressive Familial Intrahepatic Cholestasis." Medicina 57, no. 8: 854.
Background and objectives Budd-Chiari syndrome (BCS) refers to a complete thrombotic obstruction of the venous hepatic outflow tract due to various etiologies and constitutes a rare indication for ortothopic liver transplantation (LT). Few studies investigated long-term outcomes after LT for BCS. The aim of this study was to examine potential risk factors for late mortality and to evaluate long-term outcomes after LT for BCS. Materials and methods: 46 patients received an LT for BCS between 1989 and 2019 at the transplant center of the Charité-Universitätsmedizin Berlin. We analyzed potential effects of disease etiology, vascular events, rejection, and immunosuppression on long-term survival after transplantation using Kaplan-Meier curves and Cox logistic regression. Results: Of the 46 patients, 70% were female and 30% were male. Median age at the time of transplantation was 36 years. A total of 41 vascular events, including 26 thrombotic and 17 hemorrhagic incidents, occurred. The 1 year, the 5 year, the 10 year, and the 20 year survival rates were 87%, 83%, 76%, and 60%, respectively. By comparison, survival rates of the liver transplant cohort across all other indications at our center were slightly inferior with 85%, 75%, 65%, and 46%, respectively. In the study population, patients with myeloproliferative disorders showed worse outcomes compared to patients with other causes of BCS. Conclusion: Liver transplantation for BCS showed excellent results, even superior to those for other indications. Vascular events (i.e., thrombotic or hemorrhagic complications) did not have any prognostic value for overall mortality. Patients with myeloproliferative disorders seem to have a disadvantage in survival.
Marius Ibach; Dennis Eurich; Eva Dobrindt; Georg Lurje; Wenzel Schöning; Robert Öllinger; Johann Pratschke; Brigitta Globke. Orthotopic Liver Transplantation for Budd-Chiari Syndrome: Observations from a 30-Year Liver Transplant Program. Medicina 2021, 57, 821 .
AMA StyleMarius Ibach, Dennis Eurich, Eva Dobrindt, Georg Lurje, Wenzel Schöning, Robert Öllinger, Johann Pratschke, Brigitta Globke. Orthotopic Liver Transplantation for Budd-Chiari Syndrome: Observations from a 30-Year Liver Transplant Program. Medicina. 2021; 57 (8):821.
Chicago/Turabian StyleMarius Ibach; Dennis Eurich; Eva Dobrindt; Georg Lurje; Wenzel Schöning; Robert Öllinger; Johann Pratschke; Brigitta Globke. 2021. "Orthotopic Liver Transplantation for Budd-Chiari Syndrome: Observations from a 30-Year Liver Transplant Program." Medicina 57, no. 8: 821.
Background and Objectives: In children, hepatoblastoma preferentially is managed by liver resection (LR). However, in irresectable cases, liver transplantation (LT) is required. The aim of our study was to compare short- and long-term results after LR and LT for the curative treatment of hepatoblastoma. Materials and Methods: Retrospective analysis of all patients treated surgically for hepatoblastoma from January 2000 until December 2019 was performed. Demographic and clinical data were collected before and after surgery. The primary endpoints were disease free survival and patient survival. Results: In total, 38 patients were included into our analysis (n = 28 for LR, n = 10 for LT) with a median follow-up of 5 years. 36 patients received chemotherapy prior to surgery. Total hospital stay and intensive care unit (ICU) stay were significantly longer within the LT vs. the LR group (ICU 23 vs. 4 days, hospital stay 34 vs. 16 days, respectively; p< 0.001). Surgical complications (≤Clavien–Dindo 3a) were equally distributed in both groups (60% vs. 57%; p = 1.00). Severe complications (≥Clavien–Dindo 3a) were more frequent after LT (50% vs. 21.4%; p = 0.11). Recurrence rates were 10.7% for LR and 0% for LT at 5 years after resection or transplantation (p = 0.94). Overall, 5-year survival was 90% for LT and 96% for LR (p = 0.44). Conclusions: In irresectable cases, liver transplantation reveals excellent outcomes in children with hepatoblastoma with an acceptable number of perioperative complications.
Simon Moosburner; Moritz Schmelzle; Wenzel Schöning; Anika Kästner; Philippa Seika; Brigitta Globke; Tomasz Dziodzio; Johann Pratschke; Robert Öllinger; Safak Gül-Klein. Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma. Medicina 2021, 57, 819 .
AMA StyleSimon Moosburner, Moritz Schmelzle, Wenzel Schöning, Anika Kästner, Philippa Seika, Brigitta Globke, Tomasz Dziodzio, Johann Pratschke, Robert Öllinger, Safak Gül-Klein. Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma. Medicina. 2021; 57 (8):819.
Chicago/Turabian StyleSimon Moosburner; Moritz Schmelzle; Wenzel Schöning; Anika Kästner; Philippa Seika; Brigitta Globke; Tomasz Dziodzio; Johann Pratschke; Robert Öllinger; Safak Gül-Klein. 2021. "Liver Transplantation Is Highly Effective in Children with Irresectable Hepatoblastoma." Medicina 57, no. 8: 819.
Christoph Rüger; Markus A. Feufel; Simon Moosburner; Christopher Özbek; Johann Pratschke; Igor M. Sauer. Correction to: Ultrasound in augmented reality: a mixed-methods evaluation of head-mounted displays in image-guided interventions. International Journal of Computer Assisted Radiology and Surgery 2021, 1 -2.
AMA StyleChristoph Rüger, Markus A. Feufel, Simon Moosburner, Christopher Özbek, Johann Pratschke, Igor M. Sauer. Correction to: Ultrasound in augmented reality: a mixed-methods evaluation of head-mounted displays in image-guided interventions. International Journal of Computer Assisted Radiology and Surgery. 2021; ():1-2.
Chicago/Turabian StyleChristoph Rüger; Markus A. Feufel; Simon Moosburner; Christopher Özbek; Johann Pratschke; Igor M. Sauer. 2021. "Correction to: Ultrasound in augmented reality: a mixed-methods evaluation of head-mounted displays in image-guided interventions." International Journal of Computer Assisted Radiology and Surgery , no. : 1-2.
Background and Objectives: Development of hepatitis-B is considered a serious complication after liver transplantation. HBV de novo infection is a rather rare phenomenon, however it deserves attention in the era of donor organ shortage. The aim of the present analysis was to examine its course in liver transplant patients. Materials and Methods: Prevalence of de novo HBV-infections was extracted from our local transplant data base. Analysis focused on the moment of HBV-detection and on the long-term follow-up in terms of biochemical and histological changes over 30 years. Results: 46 patients were identified with the diagnosis of de novo hepatitis B. Median time from liver transplantation to diagnosis was 397 days (7–5505). 39 patients received antiviral therapy. No fibrosis progression could be detected, whereas the grade of inflammation significantly lessened from the moment of HBV detection to the end of histological follow-up over a median of 4344 days (range 123–9490). Patients with a poor virological control demonstrated a significantly poorer overall survival. Conclusions: De novo hepatitis B in liver transplant patients is a condition that can be controlled very well without significant fibrosis progression or graft loss if recognized on time within a regular transplant follow-up schedule.
Ramin Raul Ossami Saidy; Franziska Eurich; Maximilian Paul Postel; Eva Maria Dobrindt; Jasper Feldkamp; Selina Johanna Schaper; Johann Pratschke; Brigitta Globke; Dennis Eurich. Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation. Medicina 2021, 57, 767 .
AMA StyleRamin Raul Ossami Saidy, Franziska Eurich, Maximilian Paul Postel, Eva Maria Dobrindt, Jasper Feldkamp, Selina Johanna Schaper, Johann Pratschke, Brigitta Globke, Dennis Eurich. Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation. Medicina. 2021; 57 (8):767.
Chicago/Turabian StyleRamin Raul Ossami Saidy; Franziska Eurich; Maximilian Paul Postel; Eva Maria Dobrindt; Jasper Feldkamp; Selina Johanna Schaper; Johann Pratschke; Brigitta Globke; Dennis Eurich. 2021. "Clinical and Histological Long-Term Follow-Up of De Novo HBV-Infection after Liver Transplantation." Medicina 57, no. 8: 767.
Im Rahmen der COVID-19(„coronavirus disease 2019“)-Pandemie wurden weitreichende Ressourceneinschränkungen und -umverteilungen innerhalb des Gesundheitssystems notwendig. Diese Übersichtsarbeit beleuchtet die direkten und indirekten Folgen der COVID-19-Pandemie auf die Bereiche der hepatopankreatobiliären (HPB)-Chirurgie und Organtransplantation unter Berücksichtigung aktueller Literatur und veröffentlichter Expertenmeinungen nationaler und internationaler Fachgesellschaften. Entwicklungen der Operationszahlen wurden über die Eurotransplant Statistics Report Library und eine zentrumsinterne Auswertung HPB-chirurgischer Eingriffe analysiert. In den Bereichen der HPB-Chirurgie und Organtransplantation zeigte sich vor allem in der ersten Pandemiewelle an vielen Zentren ein deutlicher Einbruch der Eingriffszahlen. Interessanterweise konnte meist kein kompensatorischer Zuwachs der Operationen in den Folgemonaten verzeichnet werden. Im Jahrestrend zeigen sich somit leicht rückläufige Zahlen. Ob dieser Trend auf eine erhöhte Sterblichkeit durch verschobene Operationen und geänderte Therapieregimes zurückzuführen ist, lässt sich derzeit zumindest nicht ausschließen. Eine SARS-CoV-2(„severe acute respiratory syndrome coronavirus 2“)-Infektion ist auf jeden Fall mit einem komplikativen Verlauf assoziiert, insbesondere im perioperativen Verlauf und nach Transplantation. Aufgrund des erhöhten Risikoprofils der genannten Patientengruppen besteht ein erhöhtes Risiko für einen schweren COVID-19-Verlauf. Dies muss bei der Abwägung von Therapiealternativen, der Schutzempfehlungen und der Priorisierung bei Impfungen in Betracht gezogen werden.
K. Hillebrandt; N. Nevermann; B. Globke; S. Moosburner; M. Schmelzle; Johann Pratschke. Auswirkung der COVID-19-Pandemie auf die hepatopankreatobiliäre Chirurgie und die Organtransplantation. Der Chirurg 2021, 1 -6.
AMA StyleK. Hillebrandt, N. Nevermann, B. Globke, S. Moosburner, M. Schmelzle, Johann Pratschke. Auswirkung der COVID-19-Pandemie auf die hepatopankreatobiliäre Chirurgie und die Organtransplantation. Der Chirurg. 2021; ():1-6.
Chicago/Turabian StyleK. Hillebrandt; N. Nevermann; B. Globke; S. Moosburner; M. Schmelzle; Johann Pratschke. 2021. "Auswirkung der COVID-19-Pandemie auf die hepatopankreatobiliäre Chirurgie und die Organtransplantation." Der Chirurg , no. : 1-6.
(1) Background: Simultaneous pancreas–kidney transplantation (SPKT) is a standard therapeutic option for patients with diabetes mellitus type I and kidney failure. Early pancreas allograft failure is a complication potentially associated with worse outcomes. (2) Methods: We performed a landmark analysis to assess the impact of early pancreas graft loss within 3 months on mortality and kidney graft survival over 10 years. This retrospective single-center study included 114 adult patients who underwent an SPKT between 2005 and 2018. (3) Results: Pancreas graft survival rate was 85.1% at 3 months. The main causes of early pancreas graft loss were thrombosis (6.1%), necrosis (2.6%), and pancreatitis (2.6%). Early pancreas graft loss was not associated with reduced patient survival (p = 0.168) or major adverse cerebral or cardiovascular events over 10 years (p = 0.741) compared to patients with functioning pancreas, after 3 months. Moreover, kidney graft function (p = 0.494) and survival (p = 0.461) were not significantly influenced by early pancreas graft loss. (4) Conclusion: In this study, using the landmark analysis technique, early pancreas graft loss within 3 months did not significantly impact patient or kidney graft survival over 10 years.
Lukas Lehner; Robert Öllinger; Brigitta Globke; Marcel Naik; Klemens Budde; Johann Pratschke; Kai-Uwe Eckardt; Andreas Kahl; Kun Zhang; Fabian Halleck. Impact of Early Pancreatic Graft Loss on Outcome after Simultaneous Pancreas–Kidney Transplantation (SPKT)—A Landmark Analysis. Journal of Clinical Medicine 2021, 10, 3237 .
AMA StyleLukas Lehner, Robert Öllinger, Brigitta Globke, Marcel Naik, Klemens Budde, Johann Pratschke, Kai-Uwe Eckardt, Andreas Kahl, Kun Zhang, Fabian Halleck. Impact of Early Pancreatic Graft Loss on Outcome after Simultaneous Pancreas–Kidney Transplantation (SPKT)—A Landmark Analysis. Journal of Clinical Medicine. 2021; 10 (15):3237.
Chicago/Turabian StyleLukas Lehner; Robert Öllinger; Brigitta Globke; Marcel Naik; Klemens Budde; Johann Pratschke; Kai-Uwe Eckardt; Andreas Kahl; Kun Zhang; Fabian Halleck. 2021. "Impact of Early Pancreatic Graft Loss on Outcome after Simultaneous Pancreas–Kidney Transplantation (SPKT)—A Landmark Analysis." Journal of Clinical Medicine 10, no. 15: 3237.
Due to the lack of suitable organs transplant surgeons have to accept unfavorable extended criteria donor (ECD) organs. Recently, we demonstrated that the perfusion of kidney organs with anti-human T-lymphocyte globulin (ATLG) prior to transplantation ameliorates ischemia-reperfusion injury (IRI). Here, we report on the results of perioperative ATLG perfusion in a randomized, single-blinded, placebo-controlled, feasibility trial (RCT) involving 30 liver recipients (LTx). Organs were randomly assigned for perfusion with ATLG/Grafalon® (AP) (n = 16) or saline only (control perfusion = CP) (n = 14) prior to implantation. The primary endpoint was defined as graft function reflected by aspartate transaminase (AST) values at day 7 post-transplantation (post-tx). With respect to the primary endpoint, no significant differences in AST levels were shown in the intervention group at day 7 (AP: 53.0 ± 21.3 mg/dL, CP: 59.7 ± 59.2 mg/dL, p = 0.686). Similarly, exploratory analysis of secondary clinical outcomes (e.g., patient survival) and treatment-specific adverse events revealed no differences between the study groups. Among liver transplant recipients, pre-operative organ perfusion with ATLG did not improve short-term outcomes, compared to those who received placebo perfusion. However, ATLG perfusion of liver grafts was proven to be a safe procedure without the occurrence of relevant adverse events.
Paul Ritschl; Julia Günther; Lena Hofhansel; Stefanie Ernst; Susanne Ebner; Arne Sattler; Sascha Weiß; Annemarie Weissenbacher; Rupert Oberhuber; Benno Cardini; Robert Öllinger; Matthias Biebl; Christian Denecke; Christian Margreiter; Thomas Resch; Stefan Schneeberger; Manuel Maglione; Katja Kotsch; Johann Pratschke. Perioperative Perfusion of Allografts with Anti-Human T-lymphocyte Globulin Does Not Improve Outcome Post Liver Transplantation—A Randomized Placebo-Controlled Trial. Journal of Clinical Medicine 2021, 10, 2816 .
AMA StylePaul Ritschl, Julia Günther, Lena Hofhansel, Stefanie Ernst, Susanne Ebner, Arne Sattler, Sascha Weiß, Annemarie Weissenbacher, Rupert Oberhuber, Benno Cardini, Robert Öllinger, Matthias Biebl, Christian Denecke, Christian Margreiter, Thomas Resch, Stefan Schneeberger, Manuel Maglione, Katja Kotsch, Johann Pratschke. Perioperative Perfusion of Allografts with Anti-Human T-lymphocyte Globulin Does Not Improve Outcome Post Liver Transplantation—A Randomized Placebo-Controlled Trial. Journal of Clinical Medicine. 2021; 10 (13):2816.
Chicago/Turabian StylePaul Ritschl; Julia Günther; Lena Hofhansel; Stefanie Ernst; Susanne Ebner; Arne Sattler; Sascha Weiß; Annemarie Weissenbacher; Rupert Oberhuber; Benno Cardini; Robert Öllinger; Matthias Biebl; Christian Denecke; Christian Margreiter; Thomas Resch; Stefan Schneeberger; Manuel Maglione; Katja Kotsch; Johann Pratschke. 2021. "Perioperative Perfusion of Allografts with Anti-Human T-lymphocyte Globulin Does Not Improve Outcome Post Liver Transplantation—A Randomized Placebo-Controlled Trial." Journal of Clinical Medicine 10, no. 13: 2816.
The COVID-19 pandemic challenges international and national healthcare systems. In the field of thoracic surgery, procedures may be deferred due to mandatory constraints of the access to diagnostics, staff and follow-up facilities. There is a lack of prospective data on the management of benign and malignant thoracic conditions in the pandemic. Therefore, we derived recommendations from 14 thoracic societies to address key questions on the topic of COVID-19 in the field of thoracic surgery. Respective recommendations were extracted and the degree of consensus among different organizations was calculated. A high degree of consensus was found to temporarily suspend non-critical elective procedures or procedures for benign conditions and to prioritize patients with symptomatic or advanced cancer. Prior to hospitalization, patients should be screened for respiratory symptoms indicating possible COVID-19 infection and most societies recommended to screen all patients for COVID-19 prior to admission. There was a weak consensus on the usage of serology tests and CT scans for COVID-19 diagnostics. Nearly all societies suggested to postpone elective procedures in patients with suspected or confirmed COVID-19 and recommended constant reevaluation of these patients. Additionally, we summarized recommendations focusing on precautions in the theater and the management of chest drains. This study provides a novel approach to informed guidance for thoracic surgeons during the COVID-19 pandemic in the absence of scientific evidence-based data.
Tomasz Dziodzio; Sebastian Knitter; Helen Wu; Paul Ritschl; Karl-Herbert Hillebrandt; Maximilian Jara; Andrzej Juraszek; Robert Öllinger; Johann Pratschke; Jens Rückert; Jens Neudecker. Thoracic Surgery in the COVID-19 Pandemic: A Novel Approach to Reach Guideline Consensus. Journal of Clinical Medicine 2021, 10, 2769 .
AMA StyleTomasz Dziodzio, Sebastian Knitter, Helen Wu, Paul Ritschl, Karl-Herbert Hillebrandt, Maximilian Jara, Andrzej Juraszek, Robert Öllinger, Johann Pratschke, Jens Rückert, Jens Neudecker. Thoracic Surgery in the COVID-19 Pandemic: A Novel Approach to Reach Guideline Consensus. Journal of Clinical Medicine. 2021; 10 (13):2769.
Chicago/Turabian StyleTomasz Dziodzio; Sebastian Knitter; Helen Wu; Paul Ritschl; Karl-Herbert Hillebrandt; Maximilian Jara; Andrzej Juraszek; Robert Öllinger; Johann Pratschke; Jens Rückert; Jens Neudecker. 2021. "Thoracic Surgery in the COVID-19 Pandemic: A Novel Approach to Reach Guideline Consensus." Journal of Clinical Medicine 10, no. 13: 2769.
Background: To assess the impact of body composition imaging biomarkers in computed tomography (CT) on the perioperative morbidity and survival after surgery of patients with esophageal cancer (EC). Methods: Eighty-five patients who underwent esophagectomy for locally advanced EC after neoadjuvant therapy between 2014 and 2019 were retrospectively enrolled. Pre- and postoperative CT scans were used to assess the body composition imaging biomarkers (visceral (VAT) and subcutaneous adipose tissue (SAT) areas, psoas muscle area (PMA) and volume (PMV), total abdominal muscle area (TAMA)). Sarcopenia was defined as lumbar skeletal muscle index (LSMI) ≤38.5 cm2/m2 in women and ≤52.4 cm2/m2 in men. Patients with a body mass index (BMI) of ≥30 were considered obese. These imaging biomarkers were correlated with major complications, anastomotic leakage, postoperative pneumonia, duration of postoperative hospitalization, disease-free survival (DFS), and overall survival (OS). Results: Preoperatively, sarcopenia was identified in 58 patients (68.2%), and sarcopenic obesity was present in 7 patients (8.2%). Sarcopenic patients were found to have an elevated risk for the occurrence of major complications (OR: 2.587, p = 0.048) and prolonged hospitalization (32 d vs. 19 d, p = 0.040). Patients with sarcopenic obesity had a significantly higher risk for postoperative pneumonia (OR: 6.364 p = 0.018) and a longer postoperative hospital stay (71 d vs. 24 d, p = 0.021). Neither sarcopenia nor sarcopenic obesity was an independent risk factor for the occurrence of anastomotic leakage (p > 0.05). Low preoperative muscle biomarkers (PMA and PMV) and their decrease (ΔPMV and ΔTAMA) during the follow-up period significantly correlated with shorter DFS and OS (p = 0.005 to 0.048). Conclusion: CT body composition imaging biomarkers can identify high-risk patients with locally advanced esophageal cancer undergoing surgery. Sarcopenic patients have a higher risk of major complications, and patients with sarcopenic obesity are more prone to postoperative pneumonia. Sarcopenia and sarcopenic obesity are both subsequently associated with a prolonged hospitalization. Low preoperative muscle mass and its decrease during the postoperative follow-up are associated with lower DFS and OS.
Uli Fehrenbach; Tilo Wuensch; Pia Gabriel; Laura Segger; Takeru Yamaguchi; Timo Auer; Nick Beetz; Christian Denecke; Dino Kröll; Jonas Raakow; Sebastian Knitter; Sascha Chopra; Peter Thuss-Patience; Johann Pratschke; Bernd Hamm; Matthias Biebl; Dominik Geisel. CT Body Composition of Sarcopenia and Sarcopenic Obesity: Predictors of Postoperative Complications and Survival in Patients with Locally Advanced Esophageal Adenocarcinoma. Cancers 2021, 13, 2921 .
AMA StyleUli Fehrenbach, Tilo Wuensch, Pia Gabriel, Laura Segger, Takeru Yamaguchi, Timo Auer, Nick Beetz, Christian Denecke, Dino Kröll, Jonas Raakow, Sebastian Knitter, Sascha Chopra, Peter Thuss-Patience, Johann Pratschke, Bernd Hamm, Matthias Biebl, Dominik Geisel. CT Body Composition of Sarcopenia and Sarcopenic Obesity: Predictors of Postoperative Complications and Survival in Patients with Locally Advanced Esophageal Adenocarcinoma. Cancers. 2021; 13 (12):2921.
Chicago/Turabian StyleUli Fehrenbach; Tilo Wuensch; Pia Gabriel; Laura Segger; Takeru Yamaguchi; Timo Auer; Nick Beetz; Christian Denecke; Dino Kröll; Jonas Raakow; Sebastian Knitter; Sascha Chopra; Peter Thuss-Patience; Johann Pratschke; Bernd Hamm; Matthias Biebl; Dominik Geisel. 2021. "CT Body Composition of Sarcopenia and Sarcopenic Obesity: Predictors of Postoperative Complications and Survival in Patients with Locally Advanced Esophageal Adenocarcinoma." Cancers 13, no. 12: 2921.
The implementation of a pancreatico-enteric anastomosis following open single stage pancreaticoduodenectomy (PD) is still associated with the most threatening complications in modern pancreatic surgery, such as postoperative pancreatic fistula (POPF), postpancreatectomy haemorrhage (PPH), delayed gastric emptying (DGE), intraabdominal abscesses and related mortality. With this study, we introduce Charité-PG, a new dorsal incision only invagination type pancreatogastrostomy (dioPG) for the restoration of the pancreatic remnant following PD, and compare it to a PG requiring ventral gastrotomy (vgPG). A total of 49 consecutive patients, who underwent reconstruction via dioPG, and 92 consecutive patients, who underwent restoration via vgPG, were identified from our prospective database and further reviewed for perioperative parameters, complication rates, mortality and follow-up. The percentage of overall complications (p = 0.301), as well as the 30-day mortality rate (p = 0.725) and survival (p = 0.543), were comparable in both groups. The operation time in the dioPG group was significantly shorter (p = 0.04), and patients in this group developed substantially fewer rates of DGE (p = 0.036). We provide a feasible and safe technique for restoration following PD via our novel dioPG, causing fewer cases of DGE. Nevertheless, pancreatico-enteric anastomoses require expertise and experience.
Lea Timmermann; Marcus Bahra; Johann Pratschke; Thomas Malinka. Development of a Novel Dorsal Incision Only Invagination Type Pancreatogastrostomy (Charité-PG) Following Open Pancreaticoduodenectomy—A Single Centre Experience. Journal of Clinical Medicine 2021, 10, 2573 .
AMA StyleLea Timmermann, Marcus Bahra, Johann Pratschke, Thomas Malinka. Development of a Novel Dorsal Incision Only Invagination Type Pancreatogastrostomy (Charité-PG) Following Open Pancreaticoduodenectomy—A Single Centre Experience. Journal of Clinical Medicine. 2021; 10 (12):2573.
Chicago/Turabian StyleLea Timmermann; Marcus Bahra; Johann Pratschke; Thomas Malinka. 2021. "Development of a Novel Dorsal Incision Only Invagination Type Pancreatogastrostomy (Charité-PG) Following Open Pancreaticoduodenectomy—A Single Centre Experience." Journal of Clinical Medicine 10, no. 12: 2573.
Laparoscopic liver resection (LLR) is an increasingly relevant treatment option for patients with resectable hepatocellular carcinoma (HCC). Orthotopic liver transplantation (OLT) has been considered optimal treatment for HCC in cirrhosis, but is challenged by rising organ scarcity. While health-related quality of life (HRQoL) and mental health are well-documented after OLT, little is known about HRQoL in HCC patients after LLR. We identified all HCC patients who underwent LLR at our hospital between 2014 and 2018. HRQoL and mental health were assessed using the Short Form 36 and the Hospital Anxiety and Depression Scale, respectively. Outcomes were compared to a historic cohort of HCC patients after OLT. Ninety-eight patients received LLR for HCC. Postoperative morbidity was 25% with 17% minor complications. LLR patients showed similar overall HRQoL and mental health to OLT recipients, except for lower General Health (p = 0.029) and higher anxiety scores (p = 0.010). We conclude that LLR can be safely performed in patients with HCC, with or without liver cirrhosis. The postoperative HRQoL and mental health are comparable to that of OLT recipients in most aspects. LLR should thus always be considered an alternative to OLT, especially in times of organ shortage.
Linda Feldbrügge; Alexander Langenscheidt; Felix Krenzien; Mareike Schulz; Nicco Krezdorn; Kaan Kamali; Andreas Hinz; Michael Bartels; Panagiotis Fikatas; Moritz Schmelzle; Johann Pratschke; Christian Benzing. Health-Related Quality of Life and Mental Health after Surgical Treatment of Hepatocellular Carcinoma in the Era of Minimal-Invasive Surgery: Resection versus Transplantation. Healthcare 2021, 9, 694 .
AMA StyleLinda Feldbrügge, Alexander Langenscheidt, Felix Krenzien, Mareike Schulz, Nicco Krezdorn, Kaan Kamali, Andreas Hinz, Michael Bartels, Panagiotis Fikatas, Moritz Schmelzle, Johann Pratschke, Christian Benzing. Health-Related Quality of Life and Mental Health after Surgical Treatment of Hepatocellular Carcinoma in the Era of Minimal-Invasive Surgery: Resection versus Transplantation. Healthcare. 2021; 9 (6):694.
Chicago/Turabian StyleLinda Feldbrügge; Alexander Langenscheidt; Felix Krenzien; Mareike Schulz; Nicco Krezdorn; Kaan Kamali; Andreas Hinz; Michael Bartels; Panagiotis Fikatas; Moritz Schmelzle; Johann Pratschke; Christian Benzing. 2021. "Health-Related Quality of Life and Mental Health after Surgical Treatment of Hepatocellular Carcinoma in the Era of Minimal-Invasive Surgery: Resection versus Transplantation." Healthcare 9, no. 6: 694.
Patients after LT due to combined HBV/HDV infection are considered to be high-risk patients for recurrence of hepatitis B and D. To date, life-long prophylaxis with hepatitis B immunoglobulin (HBIG) and replication control with nucleos(t)ide analogs (NA) remains standard. We examined the course of 36 patients that underwent liver transplantation from 1989 to 2020 for combined HBV/HDV-associated end-stage liver disease in this retrospective study. Seventeen patients eventually discontinued HBIG therapy for various reasons. Their graft function, histopathological findings from routine liver biopsies and overall survival were compared with those that received an unaltered NA-based standard regimen combined with HBIG. The median follow-up was 204 and 227 months, respectively. The recurrence of HBV was 25% and did not differ between the groups of standard reinfection prophylaxis NA/HBIG (21.1%) and HBIG discontinuation (29.4%); (p = 0.56). No significant differences were found regarding the clinical course or histopathological aspects of liver tissue damage (inflammation, fibrosis, steatosis) between these two groups. Overall, and adjusted survival did not differ between the groups. Discontinuation of HBIG in stable patients after LT for combined HBV/HDV did not lead to impaired overall survival or higher recurrence rate of HBV/HDV infection in this long-term follow-up. Therefore, the recommendation of the duration of HBG administration must be questioned. The earliest time of discontinuation remains unclear.
Ramin Ossami Saidy; Irina Sud; Franziska Eurich; Mustafa Aydin; Maximilian Postel; Eva Dobrindt; Johann Pratschke; Dennis Eurich. Discontinuation of Passive Immunization Is Safe after Liver Transplantation for Combined HBV/HDV Infection. Viruses 2021, 13, 904 .
AMA StyleRamin Ossami Saidy, Irina Sud, Franziska Eurich, Mustafa Aydin, Maximilian Postel, Eva Dobrindt, Johann Pratschke, Dennis Eurich. Discontinuation of Passive Immunization Is Safe after Liver Transplantation for Combined HBV/HDV Infection. Viruses. 2021; 13 (5):904.
Chicago/Turabian StyleRamin Ossami Saidy; Irina Sud; Franziska Eurich; Mustafa Aydin; Maximilian Postel; Eva Dobrindt; Johann Pratschke; Dennis Eurich. 2021. "Discontinuation of Passive Immunization Is Safe after Liver Transplantation for Combined HBV/HDV Infection." Viruses 13, no. 5: 904.
Introduction: Recurrence of hepatocellular carcinoma (rHCC) after liver transplantation (LT) is associated with limited survival. Therefore, identification of factors that prolong survival in these patients is of great interest. Surgical resection, radiotherapy, and transarterial chemoembolization (TACE) are established interventions to improve outcomes in these patients; however, the impact of immunosuppression is unknown. Methods: All patients diagnosed with rHCC in the follow-up after LT were identified from a database of liver recipients transplanted between 1988 and 2019 at our institution (Charité Universitätsmedizin Berlin, Germany). Based on the immunosuppressive regimen following diagnosis of rHCC and the oncological treatment approach, survival analysis was performed. Results: Among 484 patients transplanted for HCC, 112 (23.1%) developed rHCC in the follow-up. Recurrent HCC was diagnosed at a median interval of 16.0 months (range 1.0–203.0), with the majority presenting early after transplantation (63.0%, <2 years). Median survival after rHCC diagnosis was 10.6 months (0.3–228.7). Reduction of immunosuppression was associated with improved survival, particularly in patients with palliative treatment (8.4 versus 3.0 months). In addition, greater reduction of immunosuppression seemed to be associated with greater prolongation of survival. Graft rejection after reduction was uncommon (n = 7, 6.8%) and did not result in any graft loss. Patients that underwent surgical resection showed improved survival rates (median 19.5 vs. 8.7 months). Conclusion: Reduction of immunosuppressive therapy after rHCC diagnosis is associated with prolonged survival in LT patients. Therefore, reduction of immunosuppression should be an early intervention following diagnosis. In addition, surgical resection should be attempted, if technically feasible and oncologically meaningful.
Ramin Ossami Saidy; Maximilian Postel; Michael Pflüger; Wenzel Schoening; Robert Öllinger; Safak Gül-Klein; Moritz Schmelzle; Frank Tacke; Johann Pratschke; Dennis Eurich. Minimization of Immunosuppressive Therapy Is Associated with Improved Survival of Liver Transplant Patients with Recurrent Hepatocellular Carcinoma. Cancers 2021, 13, 1617 .
AMA StyleRamin Ossami Saidy, Maximilian Postel, Michael Pflüger, Wenzel Schoening, Robert Öllinger, Safak Gül-Klein, Moritz Schmelzle, Frank Tacke, Johann Pratschke, Dennis Eurich. Minimization of Immunosuppressive Therapy Is Associated with Improved Survival of Liver Transplant Patients with Recurrent Hepatocellular Carcinoma. Cancers. 2021; 13 (7):1617.
Chicago/Turabian StyleRamin Ossami Saidy; Maximilian Postel; Michael Pflüger; Wenzel Schoening; Robert Öllinger; Safak Gül-Klein; Moritz Schmelzle; Frank Tacke; Johann Pratschke; Dennis Eurich. 2021. "Minimization of Immunosuppressive Therapy Is Associated with Improved Survival of Liver Transplant Patients with Recurrent Hepatocellular Carcinoma." Cancers 13, no. 7: 1617.
Diaphragmatic hernia (DH) after a liver resection (LR) is an uncommon but potentially severe complication. In this retrospective study, we aim to share our experience with DH in our hepatic surgery center. We retrospectively analyzed 3107 patients who underwent a liver resection between January 2012 and September 2019. The diagnosis of DH was based on clinical examination and radiological imaging and confirmed by intraoperative findings during surgical repair. Five out of 3107 (0.16%) patients after LR developed DH. Especially, all five DH patients had a major right-sided LR before (n = 716, 0.7%). The mean time interval between initial LR and occurrence of DH was 30 months (range 15 to 44 months). DH exclusively occurred after a right or extended right hepatectomy. Two patients underwent emergency surgery, three were asymptomatic, and DH was diagnosed in follow-up imaging. Three of these five treated patients (60%) developed DH recurrence: two of three (67%) patients after suture repair alone and the only patient after suture repair in combination with an absorbable mesh. The patient who was treated with a composite mesh implant did not show any signs of DH recurrence after 52 months of follow-up. In patients who develop DH after liver surgery, a mesh augmentation with nonresorbable material is generally recommended. In order to diagnose these patients in an early state, we recommend that special attention be paid and a prompt and targeted diagnostic examination of patients with abdominal complaints after right-sided liver resections take place.
Jonas Raakow; Ioannis-Fivos Megas; Moritz Schmelzle; Wenzel Schoening; Georg Lurje; Matthias Biebl; Johann Pratschke; Panagiotis Fikatas. Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections. Journal of Clinical Medicine 2021, 10, 1011 .
AMA StyleJonas Raakow, Ioannis-Fivos Megas, Moritz Schmelzle, Wenzel Schoening, Georg Lurje, Matthias Biebl, Johann Pratschke, Panagiotis Fikatas. Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections. Journal of Clinical Medicine. 2021; 10 (5):1011.
Chicago/Turabian StyleJonas Raakow; Ioannis-Fivos Megas; Moritz Schmelzle; Wenzel Schoening; Georg Lurje; Matthias Biebl; Johann Pratschke; Panagiotis Fikatas. 2021. "Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections." Journal of Clinical Medicine 10, no. 5: 1011.
The trace element selenium (Se) is taken up from the diet and is metabolized mainly by hepatocytes. Selenoprotein P (SELENOP) constitutes the liver-derived Se transporter. Biosynthesis of extracellular glutathione peroxidase (GPx3) in kidney depends on SELENOP-mediated Se supply. We hypothesized that peri-operative Se status may serve as a useful prognostic marker for the outcome in patients undergoing liver transplantation due to hepatocellular carcinoma. Serum samples from liver cancer patients were routinely collected before and after transplantation. Concentrations of serum SELENOP and total Se as well as GPx3 activity were determined by standardized tests and related to survival, etiology of cirrhosis/carcinoma, preoperative neutrophiles, lymphocytes, thyrotropin (TSH) and Child–Pugh and Model for End-Stage Liver Disease (MELD) scores. A total of 221 serum samples from 79 transplanted patients were available for analysis. The Se and SELENOP concentrations were on average below the reference ranges of healthy subjects. Patients with ethanol toxicity-dependent etiology showed particularly low SELENOP and Se concentrations and GPx3 activity. Longitudinal analysis indicated declining Se concentrations in non-survivors. We conclude that severe liver disease necessitating organ replacement is characterized by a pronounced Se deficit before, during and after transplantation. A recovering Se status after surgery is associated with positive prognosis, and an adjuvant Se supplementation may, thus, support convalescence.
Safak Gül-Klein; Deana Haxhiraj; Julian Seelig; Anika Kästner; Julian Hackler; Qian Sun; Raban Heller; Nils Lachmann; Johann Pratschke; Moritz Schmelzle; Lutz Schomburg. Serum Selenium Status as a Diagnostic Marker for the Prognosis of Liver Transplantation. Nutrients 2021, 13, 619 .
AMA StyleSafak Gül-Klein, Deana Haxhiraj, Julian Seelig, Anika Kästner, Julian Hackler, Qian Sun, Raban Heller, Nils Lachmann, Johann Pratschke, Moritz Schmelzle, Lutz Schomburg. Serum Selenium Status as a Diagnostic Marker for the Prognosis of Liver Transplantation. Nutrients. 2021; 13 (2):619.
Chicago/Turabian StyleSafak Gül-Klein; Deana Haxhiraj; Julian Seelig; Anika Kästner; Julian Hackler; Qian Sun; Raban Heller; Nils Lachmann; Johann Pratschke; Moritz Schmelzle; Lutz Schomburg. 2021. "Serum Selenium Status as a Diagnostic Marker for the Prognosis of Liver Transplantation." Nutrients 13, no. 2: 619.
Minimal-invasive techniques are increasingly applied in clinical practice and have contributed towards improving postoperative outcomes. While comparing favorably with open surgery in terms of safety, the occurrence of severe complications remains a grave concern. To date, no objective predictive system has been established to guide clinicians in estimating complication risks as the relative contribution of general patient health, liver function and surgical parameters remain unclear. Here, we perform a single-center analysis of all consecutive patients undergoing laparoscopic liver resection for primary hepatic malignancies since 2010. Among the 210 patients identified, 32 developed major complications. Several independent predictors were identified through a multivariate analysis, defining a preoperative model: diabetes, history of previous hepatectomy, surgical approach, alanine aminotransferase levels and lesion entity. The addition of operative time and whether conversion was required significantly improved predictions and were thus incorporated into the postoperative model. Both models were able to identify patients with major complications with acceptable performance (area under the receiver-operating characteristic curve (AUC) for a preoperative model = 0.77 vs. postoperative model = 0.80). Internal validation was performed and confirmed the discriminatory ability of the models. An easily accessible online tool was deployed in order to estimate probabilities of severe complication without the need for manual calculation.
Philipp Haber; Christoph Maier; Anika Kästner; Linda Feldbrügge; Santiago Ortiz Galindo; Dominik Geisel; Uli Fehrenbach; Matthias Biebl; Felix Krenzien; Christian Benzing; Wenzel Schöning; Johann Pratschke; Moritz Schmelzle. Predicting the Risk of Postoperative Complications in Patients Undergoing Minimally Invasive Resection of Primary Liver Tumors. Journal of Clinical Medicine 2021, 10, 685 .
AMA StylePhilipp Haber, Christoph Maier, Anika Kästner, Linda Feldbrügge, Santiago Ortiz Galindo, Dominik Geisel, Uli Fehrenbach, Matthias Biebl, Felix Krenzien, Christian Benzing, Wenzel Schöning, Johann Pratschke, Moritz Schmelzle. Predicting the Risk of Postoperative Complications in Patients Undergoing Minimally Invasive Resection of Primary Liver Tumors. Journal of Clinical Medicine. 2021; 10 (4):685.
Chicago/Turabian StylePhilipp Haber; Christoph Maier; Anika Kästner; Linda Feldbrügge; Santiago Ortiz Galindo; Dominik Geisel; Uli Fehrenbach; Matthias Biebl; Felix Krenzien; Christian Benzing; Wenzel Schöning; Johann Pratschke; Moritz Schmelzle. 2021. "Predicting the Risk of Postoperative Complications in Patients Undergoing Minimally Invasive Resection of Primary Liver Tumors." Journal of Clinical Medicine 10, no. 4: 685.
Background and objectives: The Notch signaling pathway plays an important role both in the development of the ductal systems of the pancreas and the bile ducts as well as in cancer development and progression. The aim of this study was to examine the expression of central proteins of the Notch signaling pathway in pancreatobiliary tumors and its influence on patient survival. Materials and Methods: We compared the receptors (Notch1, Notch4), activating splicing factors (ADAM17), and target genes (HES1) of the Notch pathway and progenitor cell markers with relevance for the Notch signaling pathway (CD44, MSI1) between pancreatic adenocarcinomas (PDAC, n = 14), intrahepatic cholangiocarcinoma (iCC, n = 24), and extrahepatic cholangiocarcinoma (eCC, n = 22) cholangiocarcinomas via immunohistochemistry and ImageJ software-assisted analysis. An Immunohistochemistry (IHC)-score was determined by the percentage and intensity of stained (positive) cells (scale 0–7) and normal and malignant tissue was compared. In the IHC results, patients’ (gender, age) and tumor (TNM Classification of Malignant Tumors, Union Internationale contre le Cancer (UICC) stages, grading, and lymphangitic carcinomatosa) characteristics were correlated to patient survival. Results: For eCC, the expression of CD44 (p = 0.043, IHC-score 3.94 vs. 3.54) and for iCC, the expression of CD44 (p = 0.026, IHC-score 4.04 vs. 3.48) and Notch1 (p < 0.001, IHC-score 2.87 vs. 1.78) was significantly higher in the tumor compared to non-malignant tissue. For PDAC, the expression of ADAM17 (p = 0.008, IHC-score 3.43 vs. 1.73), CD44 (p = 0.012, IHC-score 3.64 vs. 2.27), Notch1 (p = 0.012, IHC-score 2.21 vs. 0.64), and Notch4 (p = 0.008, IHC-score 2.86 vs. 0.91) was significantly higher in the tumor tissue. However, none of the analyzed Notch-signaling related components showed an association to patient survival. Conclusion: A significant overexpression of almost all studied components of the Notch signaling pathway can be found in the tumor tissue, however, without a significant influence on patient survival. Therefore, further studies are warranted to draw conclusions on Notch pathway’s relevance for patient survival.
Francesca Borlak; Anja Reutzel-Selke; Anja Schirmeier; Julia Gogolok; Ellen von Hoerschelmann; Igor Sauer; Johann Pratschke; Marcus Bahra; Rosa Schmuck. Notch Signaling Pathway in Pancreatobiliary Tumors. Medicina 2021, 57, 105 .
AMA StyleFrancesca Borlak, Anja Reutzel-Selke, Anja Schirmeier, Julia Gogolok, Ellen von Hoerschelmann, Igor Sauer, Johann Pratschke, Marcus Bahra, Rosa Schmuck. Notch Signaling Pathway in Pancreatobiliary Tumors. Medicina. 2021; 57 (2):105.
Chicago/Turabian StyleFrancesca Borlak; Anja Reutzel-Selke; Anja Schirmeier; Julia Gogolok; Ellen von Hoerschelmann; Igor Sauer; Johann Pratschke; Marcus Bahra; Rosa Schmuck. 2021. "Notch Signaling Pathway in Pancreatobiliary Tumors." Medicina 57, no. 2: 105.
Robotic assisted minimally invasive surgery has been implemented to overcome typical limitations of conventional laparoscopy such as lack of angulation, especially during creation of biliary and pancreatic anastomoses. With this retrospective analysis, we provide our experience with the first 101 consecutive robotic pancreatic resection performed at our center. Distal pancreatectomies (RDP, N = 44), total pancreatectomies (RTP, N = 3) and pancreaticoduodenectomies (RPD, N = 54) were included. Malignancy was found in 45.5% (RDP), 66.7% (RTP) and 61% (RPD). Procedure times decreased from the first to the second half of the cohort for RDP (218 min vs. 128 min, p = 0.02) and RPD (378 min vs. 271 min, p < 0.001). Overall complication rate was 63%, 33% and 66% for RPD, RPT and RDP, respectively. Reintervention and reoperation rates were 41% and 17% (RPD), 33% and 0% (RTP) and 50% and 11.4% (RPD), respectively. The thirty-day mortality rate was 5.6% for RPD and nil for RTP and RDP. Overall complication rate remained stable throughout the study period. In this series, implementation of robotic pancreas surgery was safe and feasible. Final evaluation of the anastomoses through the median retrieval incision compensated for the lack of haptic feedback during reconstruction and allowed for secure minimally invasive resection and reconstruction.
Lea Timmermann; Matthias Biebl; Moritz Schmelzle; Marcus Bahra; Thomas Malinka; Johann Pratschke. Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases. Journal of Clinical Medicine 2021, 10, 229 .
AMA StyleLea Timmermann, Matthias Biebl, Moritz Schmelzle, Marcus Bahra, Thomas Malinka, Johann Pratschke. Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases. Journal of Clinical Medicine. 2021; 10 (2):229.
Chicago/Turabian StyleLea Timmermann; Matthias Biebl; Moritz Schmelzle; Marcus Bahra; Thomas Malinka; Johann Pratschke. 2021. "Implementation of Robotic Assistance in Pancreatic Surgery: Experiences from the First 101 Consecutive Cases." Journal of Clinical Medicine 10, no. 2: 229.
Introduction: The laparoscopic approach for TME is proven to be non-inferior in oncological outcome compared to open surgery. Anatomical limitations in the male and obese pelvis with resulting pathological shortcomings and high conversion rates were stimuli for alternative approaches. The transanal approach for TME (TaTME) was introduced to overcome these limitations. The aim of this study was to evaluate the outcomes of TaTME for mid and low rectal cancer at our center. Methods: TaTME is a hybrid procedure of simultaneously laparoscopic and transanal mesorectal excision. A retrospective analysis of all consecutive TaTME procedures performed at our center for mid and low rectal cancer between December 2014 and January 2020 was conducted. Results: A total of 157 patients underwent TaTME, with 72.6% receiving neoadjuvant chemoradiation. Mean tumor height was 6.1 ± 2.3 cm from the anal verge, 72.6% of patients had undergone neoadjuvant chemoradiotherapy, and 34.2% of patients presented with a threatened CRM upon pretherapeutic MRI. Abdominal conversion rate was 5.7% with no conversion for the transanal dissection. Early anastomotic leakage occurred in 7.0% of the patients. Mesorectum specimen was complete in 87.3%, R1 resection rate was 4.5% (involved distal resection margin) and in 7.6%, the CRM was positive. The three-year local recurrence rate of 58 patients with a follow-up ≥ 36 months was 3.4%. Overall survival was 92.0% after 12 months, and 82.2% after 36 months. Conclusion: TaTME can be performed safely with acceptable long-term oncological outcome. Low rectal cancer can be well addressed by TaTME, which is an appropriate alternative with low conversion, local recurrence, adequate mesorectal quality and CRM positivity rates.
Luca Dittrich; Matthias Biebl; Rosa Schmuck; Safak Gül; Sascha Weiss; Oliver Haase; Michael Knoop; Ibrahim Alkatout; Johann Pratschke; Felix Aigner. Initial Experience with the Safe Implementation of Transanal Total Mesorectal Excision (TaTME) as a Standardized Procedure for Low Rectal Cancer. Journal of Clinical Medicine 2020, 10, 72 .
AMA StyleLuca Dittrich, Matthias Biebl, Rosa Schmuck, Safak Gül, Sascha Weiss, Oliver Haase, Michael Knoop, Ibrahim Alkatout, Johann Pratschke, Felix Aigner. Initial Experience with the Safe Implementation of Transanal Total Mesorectal Excision (TaTME) as a Standardized Procedure for Low Rectal Cancer. Journal of Clinical Medicine. 2020; 10 (1):72.
Chicago/Turabian StyleLuca Dittrich; Matthias Biebl; Rosa Schmuck; Safak Gül; Sascha Weiss; Oliver Haase; Michael Knoop; Ibrahim Alkatout; Johann Pratschke; Felix Aigner. 2020. "Initial Experience with the Safe Implementation of Transanal Total Mesorectal Excision (TaTME) as a Standardized Procedure for Low Rectal Cancer." Journal of Clinical Medicine 10, no. 1: 72.